By Jacqueline Abdalla
On saying goodbye- baby Kotwal was THE cutest newborn I’d ever seen. It’s hard to tell what did me in. Maybe it was his little squirrel face or the way he curled himself up to keep that skinny little body warm. Or the way he whimpered instead of crying. Really, I think it was his hair- a lush, dark blanket that softly laid over his back, arms and face. A layer of protection wonderfully beyond the common lanugo of infants. He was sent up to us from the NICU on Tuesday, stable after some scary respiratory distress. His mother had cerebral palsy. Her upper and lower extremities were contracted, so she had a hard time feeding or holding little Kotwal. But she was sweet, and always eager to know how her boy was doing. Her excitement spilled past her words, barely formed as she wrestled control of her vocal chords and tongue the same way she did her limbs. I reassured her he was perfect and well, and brought him down to her as often as possible. I saw her husband there, in her post-partum room, once- he grunted and turned away disinterested.
I examined baby Kotwal and later presented on him each morning, then checked on him frequently throughout the day. Later in the week I realized I could write my morning notes with him in one hand and a pen in the other. He fit perfectly in the nook of my left arm and added something meaningful to the numbers and paper.
On the third morning I walked in the nursery after morning report and caught a new attending showing him off to the nursing students as, “a perfect example of jaundice.” Oh, hell no. I scurried over to check him. Jaundice? He was fine when I left this morning!? She repeatedly pressed her thumb into his skin saying, “see, look!” No, I couldn’t see. He was perfect and beautiful, just like I left him- hazel skin and soft eyes. “Hmm, I can’t really appreciate it. He’s Indian and his skin has looked the same for the past couple of days. 12 and 36hr bilis were both low risk.” She looked back at me confidently, “Order a repeat bili.”
I did it myself (Nurse Pat had me practicing the day before…all in the wrist). The fur on his forehead was symbolically defiant, causing repeated error messages on the transcutaneous monitor. I nodded in agreement. Finally a number popped up. “5.2- low risk.” Damn straight.
Later that day the residents and nurses said they were unable to appreciate the jaundice- I had asked them all. At that point I realized I was asking as more than an intellectually-curious medical student. Kotwal was perfect, healthy- he needed to be. I didn’t know where his path would lead, but I knew it was treacherous. Who would show him the way?
On his day of discharge I had to leave at noon for a lecture. I held him and he whimpered. He continued to whimper despite my coddling and reassurance, which was unusual. I couldn’t leave him that way. Things were about to get rough and he needed to start off on the right foot. His futures ran through my head and tears ran down my face. He finally calmed. With a kiss I set him down and told him I loved him. I meant it.
Before walking away I gently brushed the hair on his forehead with the back of my hand. A velvet shield. Perhaps someone was watching over him, preparing him for this life.